Hassan, Senate Spar Over Medicaid

Concord — Gov. Maggie Hassan and House Speaker Terie Norelli, both Democrats, announced Wednesday that their party is willing to compromise on some aspects of a plan to expand access to health insurance in the state. By day’s end, though, Republican leaders made an announcement of their own: What the Democrats offered was not enough.

Democrats, who control the House, had proposed a program that would give adults earning up to 138 percent of the federal poverty level coverage through the same managed care insurance companies now overseeing most of the state’s Medicaid program.

Republicans, who control the Senate, have proposed allowing that population access to managed care plans for one year, and then giving them federally funded premium support for two years to buy insurance on the federal marketplace website.

“We are open to the Senate’s ideas. However, the bill as written by the Senate simply will not work,” Hassan said in a news release from her office yesterday, suggesting a potential compromise: The governor and speaker proposed adopting the Senate plan for putting people onto the marketplace, but easing some of the deadlines written into the Senate proposal.

In a statement later in the day, Senate President Chuck Morse, a Salem Republican, said that would create “an unsustainable entitlement.”

“Without definitive targets for when the newly eligible population will transition to private insurance on the exchange,” he said, “the governor’s proposal is nothing but a bridge to nowhere.”

Both initial proposals would require the state Department of Health and Human Services to submit a waiver application to the federal government to authorize the program changes. But the Senate version calls for the waiver to be written and submitted by May 1 of next year and approved by Oct. 1.

At a hearing before a Senate committee Tuesday, HHS Commissioner Nick Toumpas said he was concerned about being held accountable for the actions of the federal agencies that approve waivers.

The Senate proposal also includes cost-sharing requirements for applicants that the House plan did not, and a requirement that all able-bodied applicants for premium assistance be referred to employment counseling.

Under the Senate plan, the expansion would end entirely on Dec. 31, 2016, when federal funding under the Affordable Care Act is expected to dip from 100 percent to 95 percent of cost. The Democrats’ initial proposal called for the Legislature to re-evaluate the program only if the federal funding decreased below the levels outlined in the federal law.

The Republicans’ proposal also instructed Toumpas to include a request for federal matching funds for state spending on Medicaid outside of what the federal program covers.

Toumpas testified at the Senate committee Tuesday that consultants who worked on Arkansas’s waiver application and are now working with his office estimate that requesting funds for such costs can add six months to the approval timeline.

Democrats would be open to including such a request in the waiver application, “as long as there is a more realistic timeline in place for what would be a complicated process,” said Hassan’s spokesman Marc Goldberg.

In their statement, Hassan and Norelli noted that Arkansas, the only state to have received a waiver for a premium-assistance version of Medicaid expansion, took a full year to develop its application.

In the Republican statement, Morse said he remained confident the state could meet the deadlines outlined in the Senate bill.